الفهرس 
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Abstract
Almost all diabetic patients eventually develop skin complications from the long-term effects of diabetes mellitus on the microcirculation and on skin collagen. Skin manifestations in diabetes mellitus are common and expressed in numerous forms. If one considers metabolic effects on microcirculation and changes in skin collagen, prevalence approaches 100 percent. Findings range from the presenting manifestations of the disease to signs of long term involvement, even life-threatening problems. For all of these, recognition is the key to treatment and/or prevention. Patients who have had diabetes for many years tend to develop the most devastating skin problems. Therefore this study was carried out to study the types of cutaneous manifestations and their prevalence among diabetic children with cutaneous diseases aged ≤ 15 years with comparsion with control patients with cutaneous diseases within the same age group. This study was conducted on 304 Egyptian children (152 diabetic patients and 152 non diabetic patients who suffered from cutaneous diseases).
Our results showed that in diabetic patients, complications of insulin treatment had the highest percentage of cases (28.9%) followed by allergic skin diseases (19.1%). Pruritus came in the third order (15.1%) followed by cutaneous bacterial infections (12.5%) then cutaneous fungal infections (11.2%). In control patients, allergic skin diseases showed the highest percentage (28.9%) followed by cutaneous bacterial infections (14.5%). Parasitic infestations came in the third order (11.2%) followed by sweat rash (10.5%) then cutaneous fungal infections and hair disorders showed equal numbers of patients (8.5% each).
Complications of insulin treatment (28.9%), pigmentary disorders and nevi (2.6%), acanthosis nigricans (0.7%), keratosis pilaris (0.7%), rubeosis faciei (0.7%), and hyperhydrosis of hand (0.7%) were found in diabetic patients only. Sweat rash (10.5%), Psoriasis (0.7%), lichen nitidus (0.7%), vitiligo (1.3%), neurofibromatosis (1.3%), Becker’s nevus (0.7%), vascular nevi (2%), milia (0.7%) and Pityriasis Lichenoides Chronica (PLC) (0.7%) were found in control cases only.
from the present series we can conclude that complications of insulin treatment especially lipohypertrophy was the most prevalent cutaneous manifestation among diabetic children. Type 1 diabetic patients were less prone to develop eczema, on the other hand, pruritus is a common cutaneous symptom among Type 1 diabetic children. Contrary to the common belief, the prevalence of infections among diabetic children is not higher that their prevalence among non diabetic patients presenting with cutaneous diseases. Candidal infections especially monilial vulvovaginitis was the most common fungal infection observed in diabetic patients. Acanthosis Nigricans was observed only in diabetic patients as it is a formal risk factor for the development of diabetes in children. Keratosis pilaris and Rubeosis Faciei were also detected only in diabetic patients. Diabetics are less liable to develop sweat rash due to the neuropathy and associated anhydrosis detected in diabetic patients. Pigmentary disorders and hyperkeratosis of the sole were more prevalent in diabetic patients